Mental Health Support Groups and Stigma

So tonight I went to a support group meeting for Mothers with mental health issues. It’s the first time I’ve been to anything like this, and although of course it was triggering in terms of social anxiety, in coexistence with this experience was the most incredible feeling of warmth and safety. It was unlike anything I have experienced before.

Within minutes of the meeting a woman was relating an anecdote about a work trip away where she forgot her medication. The dual effect of hearing this small detail of someone else’s life that involved the word ‘anti-depressant,’ and feeling the instant surge of unshaken acceptance and recognition in the room was truly breathtaking.

One of the key points I came away from the evening with was how limiting limited ideas about ‘otherness’ are. Some of the women talked about the difficulties they’d had in identifying and naming what was happening to them. They talked about their symptoms not fitting with their preconceived ideas of certain illnesses or experiences, and how stultifying that was for their recovery. For example, for one woman, her experience of post natal anxiety and depression comprised a lot of physical symptoms, like nausea and unexplained pains. Plus she didn’t have any difficulties bonding with her baby, having picked up some pseudo-medical reference from somewhere or another that THAT was the defining characteristic of post-partum depression.

I can certainly relate to these experiences. I was diagnosed with bipolar II around four years ago, and have only just begun to come anywhere near an acceptance of my diagnosis. And part of the reason for that has been the extremely limited portrait of bipolar disorder that hangs on the walls of mainstream society. The other problem for me in finding myself under my label was the absurd process via which I was assigned it, and the extremely dubious grounds on which any diagnosis at all is based in the part of the world in which I live. In order to receive a diagnosis of bipolar II, it is necessary only to have had ONE experience of ‘hypomania’ in a lifetime. And really, read with a critical eye anyone with a pulse could be arguably squeezed into this box at a push. To what extent are we pathologising personality types that fail to meet the needs of a capitalist, patriarchal social structure? Or even just misinterpreting cultural difference? Sure, England isn’t a million miles away from where I live now but there are some marked cultural differences. And crudely put I would say that levels of ‘animation’ are certainly one of them!

Another woman in the group shared her doctor’s inability to accept what he perceived to be a contradiction in her symptom profile. This woman exhibits a significant and statistically satisfying majority in terms of her depressive symptoms, except for one anomaly. She continues to find social contact nourishing, even on her darkest days. And for this reason the doctor called her life experience, and the veracity of her suicidal ideations into question. ‘But surely you can’t be THAT depressed if you can still get out??’ Anyone who has ever found the courage to reach out to a professional for help with a mental illness has had an experience, perhaps many, like this. The consequences of such an interaction can be truly devastating, and the hurt, shame and anger can persist for a lifetime. It is the back-breaking double burden that so many of us carry every day. The pain itself, and the pain of having your reality denied to your face.

If a person is reporting distress, that experience needs to be accepted unconditionally. What threat are these professionals attempting to mitigate here anyway?? The question shouldn’t be ‘under which category should your distress be filed?’ Insisting on finding the correctly sized box for this formless piece of human distress, is, if you ask me, a form of neurosis in itself. The violence and harm caused by our mental health systems is arguably far more dangerous that the symptoms themselves.

The other key thing I really noticed after this wonderful evening was, however, how serious and specific the levels of shame and stigma are when it comes to alcoholism and addiction generally. I am no stranger to stigmatised identities, and actually have a pretty high tolerance threshold for owning uncomfortable labels. There’s a distinct stratification though, comprised of three levels. Level one, green light, is Anxiety and Depression. These words are fully part of our everyday vernacular, and a reasonably balanced picture of these conditions is beginning to find form in popular culture. The problem here can be convincing people as to the severity of the experience, when pretty much everyone thinks they ‘know what it is.’

Level two, amber light, is bipolar disorder. I have only really just come to see that my symptom profile DOES fit the criteria, and the RIGHT sort of targeted guidance and support COULD be useful. ‘Admitting’ to this diagnosis, however, has been far more difficult for me that owning depression and anxiety. I haven’t even told my parents that I have this condition. I have mentioned it a few times and they’ve made it fairly clear that they dispute it. So bipolar is level 2. Not something I talk about freely/generally AT ALL, and only a very small number of people know that I have this diagnosis. It was something I had no problem, however, in sharing at the support group.

Alcoholism, however, is level 3. RED LIGHT. It is not really possible to talk about this with anyone, anywhere, unless they are afflicted with the same condition. MUCH greater levels of shame are involved, at least for me anyway, which I think are directly related to the stereotyped ideas our society has about addiction, but more specifically alcoholism. I somehow feel ESPECIALLY ashamed to admit an addiction to alcohol.

I can’t help feeling a certain extra sense of grubbiness around this whole business of alcoholism. I’m having treatment in the country I’m living in, and have actually found myself lying about this to some people, saying that I’m there because of my addiction to benzodiazepines. I did have one for quite some years, but dealt with it from a purely medical perspective through my psychiatric nurse. But its funny to notice how I feel there’s more dignity in being a pill popper than being a wino. In fact, I feel I’d rather admit to an addiction to ANYTHING over admitting to alcoholism. Any kind of drug addiction feels to me just somehow slightly less moralised, with a certain pitiable victimhood about it, and just a slight touch of rock and roll. I’m not talking, of course, about the hideous and debasing reality of actually living with any kind of addiction, of course. I’m just talking about that visual that exists in the mind’s eye of society. That PERSON that pops up in your imagination when you talk about that intersection of person/substance.

So I didn’t mention this at the support group, and in no way at no point did I feel like I could. Now of course that wasn’t really what the support group was ABOUT but nonetheless I really do see addiction as a mental health situation, if not in itself then certainly as a frequent add on to other diagnoses. I read somewhere that up to 50% of people with a diagnosis of bipolar II also have a substance misuse issue. I just wish I had the balls to stand up and own it, because I know that’s the first brick in the dismantling of the great wall of stigma…. but it sure is hard to be the first one!!